U.S. suicide rate has risen sharply in the 21st century

Dr. Yeates Conwell with the Center for Study and Prevention of Suicide, University of Rochester Medical Center talks about the four D's that contribute to suicide risk in older adults. (The American Foundation for Suicide Prevention)

The U.S. suicide rate has increased sharply since the turn of the century, led by an even greater rise among middle-aged white people, particularly women, according to federal data released Friday.

Last decade’s severe recession, more drug addiction, “gray divorce,” increased social isolation, and even the rise of the Internet and social media may have contributed to the growth in suicide, according to a variety of people who study the issue.

But economic distress — and dashed hopes generally — may underpin some of the increase, particularly for middle-aged white people. The data showed a 1 percent annual increase in suicide between 1999 and 2006 but a 2 percent yearly hike after that, as the economy deteriorated, unemployment skyrocketed and millions lost their homes.

“People [were] growing up with a certain expectation . . . and the Great Recession and other things have really changed that,” said Julie A. Phillips, a professor of sociology at Rutgers University who studies the demography of suicide. “Things aren’t panning out the way people expect. I feel for sure that has had an effect.”

The study by the National Center for Health Statistics also shows an alarming jump in suffocation — mostly hangings — as a suicide method. Use of that technique rose by 89 percent, after adjusting for growth in population, and by 157 percent for white women. Experts struggled to pinpoint a reason; use of firearms and pills declined as a share of the increasing number of suicides.

Suicide remains one of the 10 leading causes of death for Americans. Its rise comes amid a long-term decline of death rates for most other major killers, such as cancer and heart disease, the result of billions of dollars spent on research and the development of new treatments.

The U.S. homicide rate is also down: There are more than two suicides for every homicide. Among whites, there are more than seven suicides for every slaying.

Along with opioid abuse and alcoholism, suicide has attracted recent attention as one of the main causes of a surprising increase in mortality for white men and women since the turn of the last century, especially for those ages 45 to 54. A study last November by Princeton University economists Anne Case and Angus Deaton, and other studies like it, have triggered new concerns about middle-aged whites, particularly people with less education and people living in rural areas, who appear to be more severely affected. Friday’s report will do nothing to allay that.

Overall, the new data show, the age-adjusted suicide rate in the United States jumped 24 percent between 1999 and 2014, from 10.5 per 100,000 people to 13 per 100,000 people. The rate increased for both sexes and in all age groups from 10 to 74. The pace has continued into the first two quarters of 2015, separate data show.

More men than women still complete suicides because they tend to use more lethal methods, such as guns and jumping from buildings or bridges. But women attempt suicide in much greater numbers.

Statistics on suicide and race released separately by the agency Friday showed that American Indians and Alaska Natives suffered the greatest rate of increase in suicides, though that population is much smaller than other ethnic groups in the United States. Whites were second. Among white women ages 45 to 64, for example, the suicide rate jumped 80 percent, from 7 per 100,000 in 1999 to 12.6 per 100,000 in 2014.

Suicide rates declined from the mid-1980s until about 2000, but rates have risen back to the level of the 1980s as the baby-boom generation has aged, said Cathy Barber of the Harvard School of Public Health.

Alex Crosby, chief of the surveillance branch in the Centers for Disease Control and Prevention’s division of violence prevention, said suicide can be influenced by many factors — some personal, some social — making it difficult to draw broad conclusions about the data.

“We know something about the risk factors going up and protective factors going down,” he said.

Suicide can be an impulsive act for some, but others engage in weeks or months of planning, he said. Being a victim of violence or child abuse increases the risk of suicide, as does having parents who are substance abusers or who have been incarcerated. Mental illness and substance abuse also are associated with higher suicide rates.

Social isolation, bullying — the old fashioned kind or cyberbullying — and the rise of the Internet may also have some influence, Crosby and others said.

Sally C. Curtin, a statistician for the National Center for Health Statistics and lead author of the study released Friday, said that “the Internet can be a double-edged sword. Prevention materials can be widely disseminated, but also you can just Google ‘suicide.’ It’s just very different how much information we have at our fingertips.”

Not only is advice about how to commit suicide easy to find online, so is essential equipment, such as the plastic bags known as “exit sacks” that are used in suffocation. Searches on Yahoo and Google for words linked to suicide brought up paid ads for advice books and other paraphernalia. Yahoo and Google said they have policies against such ads and block them whenever they find them.

Prevention is still challenging. Gun locks, nets and barriers on bridges, and safely secured medications have been shown to prevent impetuous acts, but more broad-based efforts are needed, experts said.

“We now know it’s a mental health condition. We know it’s preventable,” said Jill Harkavy-Friedman, vice president of research at the American Foundation for Suicide Prevention. “The research and the funding have not kept up with that yet. As the stigma dissipates, that is going to change. But we have to put the money behind it.”